Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 39866 | IA |
N | 2081P2900X | Pain Medicine | 39866 | IA |
NPI | 1093920258 |
---|---|
Provider Name | Dr. Azra Khan Salahuddin |
First Address | Indianapolis, IN 46202-2803 |
Second Address | Indianapolis, IN 46202-2803 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2007 |
Last Update Date | 03/11/2020 |